Willaert Wouter, Tozzi Francesca, Van Herzeele Isabelle, D'Herde Katharina, Pattyn Piet
a Department of Gastrointestinal Surgery , Ghent University Hospital , Ghent , Belgium.
b Department of Thoracic and Vascular Surgery , Ghent University Hospital , Ghent , Belgium.
Acta Chir Belg. 2018 Jun;118(3):141-151. doi: 10.1080/00015458.2017.1407099. Epub 2018 Apr 13.
The role of reperfused human cadavers in surgical training has not been established.
Reports describing reperfused human cadaver models in terms of simulated surgeries, the use of tools to assess technical competency and skills transfer to patients, cadaver status and reperfusion techniques were included.
Thirty-five reports were included. Most participants practised vascular (n = 27), flap (n = 6) and trauma (n = 4) procedures. Training progression was evaluated objectively in only two studies. In two publications, flap techniques were practised on cadavers and repeated successfully in patients. Eighteen studies employed whole bodies. Fresh and embalmed cadavers were both used in 17 publications. Most embalmed cadavers were formalin-fixed (n = 10), resulting in stiffness. Few trainings were offered on soft Thiel-embalmed cadavers (n = 5). Only arteries were reperfused in 20 studies, while in 13 publications, the arteries and veins were filled. Arteries and/or veins were mostly pressurized (n = 21) and arterial flow was generated in 14 studies.
Various reperfused human cadaver models exist, enabling practise of mainly vascular procedures. Preservation method determines the level of simulation fidelity. Thorough evaluation of these models as surgical training tools and transfer effectiveness is still lacking.
再灌注人体尸体在外科手术培训中的作用尚未确定。
纳入了描述再灌注人体尸体模型的报告，内容涉及模拟手术、用于评估技术能力和技能向患者转移的工具使用、尸体状态和再灌注技术。
共纳入35篇报告。大多数参与者练习血管手术（n = 27）、皮瓣手术（n = 6）和创伤手术（n = 4）。仅有两项研究对培训进展进行了客观评估。在两篇出版物中，在尸体上练习皮瓣技术并在患者身上成功重复。18项研究使用了全身尸体。17篇出版物中同时使用了新鲜尸体和防腐尸体。大多数防腐尸体用福尔马林固定（n = 10），导致僵硬。很少有针对Thiel软防腐尸体的培训（n = 5）。20项研究中仅对动脉进行了再灌注，而在13篇出版物中，动脉和静脉都进行了填充。动脉和/或静脉大多进行了加压（n = 21），14项研究中产生了动脉血流。
存在各种再灌注人体尸体模型，主要用于血管手术的练习。保存方法决定了模拟逼真度的水平。目前仍缺乏对这些模型作为外科手术培训工具及其转移效果的全面评估。
